An Atypical Case of Polycystic Ovarian Syndrome and Possible Newly Diagnosed Systemic Lupus Erythematosus Complicated With a Cerebrovascular Accident in a Young Female: A Case Report.

Polycystic ovary syndrome (PCOS) is the leading cause of endocrine disorders among females of reproductive age and is linked with autoimmune disorders. PCOS has been associated with autoantibodies such as antinuclear antibody (ANA), anti-thyroid, and anti-Smith (anti-SM). Young patients with PCOS and systemic lupus erythematosus (SLE) have up to a 10-fold increase in stroke. We present a case of a patient with a history of PCOS (on metformin), hypothyroidism, and pulmonary embolism who presented to the emergency room with acute left-sided weakness. She was extensively investigated for risk factors and was eventually diagnosed with a cerebrovascular accident secondary to possible SLE with positive ANA (1:160, nuclear homogenous pattern). The diagnosis of PCOS, coupled with autoantibodies and recurring episodes of thromboembolic events, rendered her case management complex. She received tenecteplase and had thrombectomy done twice because of recurrent thrombotic events during her hospital stay. She passed away on the fifth day post-thrombectomy from a possible massive pulmonary embolism with hemodynamic compromise. There is a need for more research to comprehend the underlying mechanisms of SLE and PCOS to guide the proper management of patients in this situation.

Clinical and aetiologic profile of patients with chronic urticaria at the outpatient clinic of a tertiary hospital in Lagos, Nigeria: a cross-sectional observational study.

Chronic urticaria is a condition characterized by recurrent wheals associated with itching lasting longer than six weeks. The condition tends to run a chronic course with significant morbidity. Several factors have been explored in the cause, yet the aetiology is still uncertain. We documented the clinical profile and assessed the possible aetiologic factors in patients with chronic urticaria. Clinical profile of sixty consecutive patients with chronic spontaneous urticaria was assessed with possible precipitants identified using a structured questionnaire. The complete blood count with erythrocyte sedimentation rate, antithyroid peroxidase (antiTPO), hepatitis B surface antigen (HBsAg), antihepatitis C virus screening (AntiHCV), stool for ova and parasites and helicobacter pylori were carried out. Controls without a history of urticaria were recruited in a 1: 1 ratio for stool for parasites and H. pylori because of the high prevalence rates reported in this environment. Data analysis was carried out with Statistical Packages for Social Sciences (SPSS) version 22. Sixty patients with chronic urticaria and sixty age and sex matched controls were enrolled in the study. Females presented more often with urticaria with a M: F ratio of 1: 2.5. The mean age of onset of urticaria was in the third decade of life. Precipitants were identified in close to a third of patients. The investigated antigenic aetiology was not found to play a role. The presentation and clinical profile of patients in this environment is similar to previously documented studies. History still remains the cornerstone of management as precipitants and triggers may be identified. Management of patients should therefore be individualized.

Pattern of skin diseases amongst children attending a dermatology clinic in Lagos, Nigeria.

INTRODUCTION: Skin diseases constitute a major health problem affecting a large proportion of the population including children causing distress and disability. This study aimed to document the spectrum and frequency of skin diseases of children who attended the dermatology outpatient clinic of the Lagos University Teaching Hospital (LUTH) Lagos, Nigeria. METHODS: A cross-sectional study of children (18 years old and below) who attended the dermatology clinic between January 2004 and December 2016. Data obtained from the medical records of the patients included age, gender, clinical features, laboratory features and diagnosis. Skin diseases were classified into various groups. RESULTS: There were 6373 children included in the study with a male to female ratio of 1:1.13. The most common disease categories were infections 1795 (26.1%), Eczematous conditions 1711 (24.9%), Infestations 936 (13.6%), papulosquamous disorders 547 (8.0%) and Bullous disorders 254 (3.7%). With respect to individual skin diseases, atopic dermatitis (AD) 1042 (15.1%) was the most common skin condition followed by papular urticaria 705 (10.2%) and tinea capitis 554 (8.1%). Infections were most common among infants and adolescents. Acneiform eruptions were common among adolescents while eczematous disorders were most common among children less than 5 years. CONCLUSION: The study highlights the common dermatoses seen in children in a specialized dermatology clinic in a developing country such as Nigeria. Most of the skin diseases observed can be controlled by proper environmental sanitation, adequate nutrition, reducing overcrowding, and promoting good health-seeking behavior among parents and caregivers. Information obtained from the study may guide training in dermatology especially among pediatricians.

Growing trend of tattooing and its complications in Nigeria.

Tattoo, a Polynesian word meaning 'to mark', is a form of body modification done by inserting indelible ink into the dermis to change its pigmentation. Tattoos are done for social, cultural, and religious purposes. It has been in existence since the 18th century and was associated with sailors, lower class individuals, and criminals. However, since the late 20th century, tattooing has undergone a redefinition and shifted to an acceptable form of expression all over the world, including Nigeria, cutting across almost all age groups and socioeconomic class. This review is aimed at highlighting the indication, complications arising from the procedure as well as removal, and how to manage them. The dermatological complications associated with tattoos can occur either during inking or attempts at removal. Most times, tattoos are obtained through unsafe means by unauthorized personnel, and this is associated with numerous health risks. Of particular importance to the dermatologists are the hypersensitivity reactions, granulomatous skin disease, and formation of both keloid and hypertrophic scars. Treatment options vary and include use of silicone gel and intralesional steroids for hypertrophic and keloid scars, topical medication for hyperpigmentation, and use of LASER for tattoo removal. In conclusion, the trend of tattooing has become a widely accepted form of social expression all over the world and is gradually gaining ground in Nigeria. Patients frequently present to the dermatologists and physicians for solutions to the complications. It is important to proffer solutions and educate patients on the various health risks associated with tattooing.